| Abstract | Ciljevi:. Utvrditi povezanost oralnih očitovanja upalnih bolesti crijeva (UBC) s vrstom bolesti,
aktivnosti bolesti, vrstom terapije, upalnim markerima iz krvi i stolice, koncentracijama
laktoferina i neopterina u slini te kvalitetom života povezanom s oralnim zdravljem. Utvrditi
prevalenciju specifičnih i nespecifičnih oralnih promjena, prevalenciju oportunističkih oralnih
infekcija u bolesnika na biološkoj terapiji, utjecaj oralnog zdravlja na kvalitetu života i
koncentraciju salivarnih laktoferina i neopterina u UBC ispitanika.
Ispitanici i metode: U istraživanje je uključen 71 UBC i 71 zdravi kontrolni ispitanik. Ispunili
su anamnestički upitnik, upitnik samoprocjene oralnih simptoma i znakova i upitnik
samoprocjene utjecaja oralnog zdravlja na kvalitetu života. Napravljeni su oralno klinički
pregled, obrisak oralne sluznice radi mikrobiološke analize i test lučenja nestimulirane sline.
Uzorak sline je korišten za imunoenzimsku analizu koncentracije laktoferina i neopterina.
Rezultati: S oralnim očitovanjima se prezentiralo 73,2 % UBC i 22,5 % kontrolnih ispitanika
(p=<0,001). Viša prevalencija atrofičnog glositisa (p=0,001), bijelo obloženog jezika (p=0,01),
protetskog palatitisa (p=0,006), kandidijaze (p=0,003) i hiposalivacije (p=0,000) je zabilježena
u UBC ispitanika u odnosu na kontrolne ispitanike. Dva UBC ispitanika su imala specifična
očitovanja. UBC ispitanici na anti-TNFα i anti-integrin α4β7 terapiji su imali višu prevalenciju
kandidijaze (p=0,016) u odnosu na kontrolne ispitanike. Nije bilo značajne razlike u
samoprocjeni utjecaja oralnog zdravlja na kvalitetu života između UBC i kontrolnih ispitanika
(p=0,125). Ispitanici s oralnim očitovanjem su imali veći utjecaj oralnog zdravlja na kvalitetu
života. UBC ispitanici s i bez oralnih očitovanja su imali višu koncentraciju laktoferina u slini
u ng/ml (p=0,020) u odnosu na kontrolne ispitanike, ali nije zabilježena značajna razlika u
koncentraciji salivarnog neopterina (p=0,969). Pronađena je povezanost hiposalivacije s
koncentracijom laktoferina u slini u ng/ml (p<0,01, r=0,377) i Mayo score indeksom (p<0,05,
r=0,248), atrofičnog glositisa s koncentracijom neopterina u slini u ng/ml (p<0,01, r=0,392) i
utjecajem oralnog zdravlja na kvalitetu života (p<0,001, r=0,393) te eksfolijativnog glositisa s
C-reaktivnim proteinom (p<0,01, r=0,453).
Zaključak: UBC bolesnici imaju učestalije oralne promjene u odnosu na zdrave osobe.
Uključenje specijalista oralne medicine u liječenje UBC bolesnika bi doprinijelo ranom
prepoznavanju, dijagnostici i liječenju oralnih promjena sa svrhom poboljšanja oralnog zdravlja
i njegovog utjecaja na kvalitetu života. |
| Abstract (english) | Objectives: To determine the correlation between oral manifestations (OM) of inflammatory
bowel disease (IBD) and disease type, disease activity, type of therapy, blood and faecal
inflammation markers, salivary lactoferrin and neopterin concentrations and oral health-related
quality of life. To define the prevalence of specific and non-specific OM, the prevalence of oral
opportunistic infections in subjects receiving biologic therapy, the impact of oral health on the
quality of life and concentrations of salivary lactoferrin and neopterin in IBD subjects.
Patients and methods: 71 IBD and 71 healthy control subjects were included in the study. All
subjects completed the patients’ history questionnaire, a self-assessment questionnaire on oral
symptoms and signs, and a self-assessment oral health impact questionnaire. Oral examination,
oral swab test and non-stimulated salivary flow rate were conducted. Saliva samples were used
for immunoenzyme analysis of lactoferrin and neopterin concentrations.
Results: 73.2% of IBD and 22.5% of control subjects have presented with OM (p=<0,001).
IBD subjects had a higher prevalence of atrophic glossitis (p=0.001), coated tongue (p=0.01),
denture palatitis (p=0.006), candidiasis (p=0.003) and hyposalivation (p=0,000) compared to
control subjects, while 2 IBD subjects presented with specific manifestations. IBD subjects on
anti-TNFα and anti-integrin α4β7 therapy had a higher prevalence of candidiasis (p=0.016)
compared to control subjects. No significant difference was found in self-assessment of oral
health impact on the quality of life between groups (p=0.125). Subjects with OM had higher
oral health-related quality of life impact. IBD subjects with and without OM had higher
concentrations of salivary lactoferrin (ng/ml) compared to control subjects (p=0.020), but no
significant difference was found in salivary neopterin concentrations between groups
(p=0.969). Hyposalivation was correlated with salivary lactoferrin concentration (p<0.01,
r=0.377) and Mayo score index (p<0.05, r=0.248), atrophic glossitis was correlated with
salivary neopterin concentration (p<0.01, r=0.392) and oral health-related quality of life
(p<0.001, r=0.393), while exfoliating glossitis was in correlation with C-reactive protein
(p<0.01, r=0.453).
Conclusion: IBD patients have more OM than healthy subjects. The involvement of an oral
medicine specialist in treating IBD patients could contribute to early recognition, diagnostics,
and treatment of OM for oral health improvement and its impact on quality of life |
